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Median Arcuate Ligament Syndrome

Median arcuate ligament syndrome (MALS) is a rare disorder that can cause severe upper belly pain after every meal. Vascular surgeons Danón Garrido, MD, and Justin Manley, MD at Advanced Vascular & Vein Associates in Flowood, Mississippi, offer minimally invasive surgical treatment for MALS. The procedure provides nearly immediate pain relief and is often life-changing for individuals who are struggling with MALS. Schedule an evaluation at Advanced Vascular & Vein Associates today by calling the office or requesting an appointment online.

Median Arcuate Ligament Syndrome Q & A

What is median arcuate ligament syndrome (MALS)?

The median arcuate ligament is an arched band of tough fibrous tissue that attaches the diaphragm to the spine.

Normally, the median arcuate ligament circles around the large cardiac artery (aorta), which carries blood to the body. It rests above the celiac artery, which supplies blood to the stomach, spleen, liver, and most of the pancreas.

When you have MALS, the ligament presses against the celiac artery, which restricts blood flow to organs in the upper abdomen. It may also compress a bundle of nerves (celiac plexus) that surround the celiac artery.

What are the symptoms of MALS?

Symptoms of MALS include:

Pain in the upper middle stomach area that may decrease when you lean forward
Moderate to severe stomach pain when eating, exercising, or shifting body position
Bloating
Nausea
Vomiting
Diarrhea

MALS is more common in young women but can affect individuals of any age. The symptoms often lead to food aversion and significant weight loss, which is particularly worrisome in young children.

Unfortunately, because MALS is rare and the symptoms mimic many other common stomach ailments, it’s often confused with other conditions.

How do you treat MALS?

The specialists at Advanced Vascular & Vein Associates typically begin with an evaluation to confirm MALS, which can only be treated with surgery.

Your workup may include ultrasound imaging to check blood flow through your abdominal area. Compression of the celiac artery that leads to decreased blood flow often shows up on an ultrasound.

Once the diagnosis is confirmed, your surgeon discusses surgical release of the ligament via a minimally invasive laparoscopic or robotic approach.

During minimally invasive surgery, your vascular surgeon makes several small incisions in the upper abdominal area. In these incisions, they insert surgical instruments and a small high-definition camera that transmits a real time view of the surgical site.

This approach is preferred to open, or traditional, surgery, which requires a long incision in the abdomen to access the ligament.

Benefits of minimally invasive surgery include decreased healing time, less tissue trauma during the procedure, and a quicker return to normal activity.

Most individuals require an overnight hospital stay following the procedure, which is considered safe for all age groups, even young children.

If you suspect you have MALS or have already been diagnosed with it, the vascular surgeons at Advanced Vascular & Vein Associates can help. Schedule an evaluation today by calling the office or requesting an appointment online.